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HL20: Jeffrey Brenner, MD—Providing Better Care to Complex Patients

Rene Letourneau, for HealthLeaders Media, December 19, 2013

"Everywhere I have looked, I see the same basic rule of thumb ... a small portion of the population is driving all the healthcare costs. It's a basic law of human systems that a small number of people drive many of the challenges," Brenner says.

By analyzing the medical records from the three major hospitals in Camden from 2002 through 2011, Brenner found that 1% of the city's patients generated 30% of hospital inpatient and emergency room expenses and that 20% of patients were responsible for 90% of inpatient and ER costs.

Brenner says the top reasons for ED visits among all Camden residents include basic, nonacute issues, such as head colds, ear infections, sore throats, headaches, and other nonemergent health concerns. "We are occupying emergency rooms with things that don't need it," he says. "Healthcare is incredibly expensive, and we are not getting our money's worth."

"I think it's a solvable problem, but it is such a multilayered problem," Brenner adds, noting it will take better data, workflows, physician training, and workload delegation to begin to improve care and lower the costs associated with this patient population. "You have to pull on many different levers to fix the problem."

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